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Vol. 20. Issue 3.
Pages 155-161 (March 2024)
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Vol. 20. Issue 3.
Pages 155-161 (March 2024)
Review article
Epidemiology of thromboembolic events in children and adolescents with antiphospholipid syndrome: A systematic review with meta-analysis
Epidemiología de los acontecimientos tromboembólicos en niños y adolescentes con síndrome antifosfolípido: una revisión sistemática con metaanálisis
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Mickael Essoumaa,
Corresponding author
essmic@rocketmail.com

Corresponding author.
, Jan Rene Nkeckb,c, Jean Jacques Noubiapd
a Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Yaoundé, Cameroon
b Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
c Regional Hospital Centre, Ebolowa, Cameroon
d Division of Cardiology, Department of Medicine, University of California-San Francisco, San Francisco, CA, United States
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Abstract
Background and aim

This was a systematic review and meta-analysis of the prevalence of thromboembolic events in children and adolescents with antiphospholipid syndrome (APS).

Methods

We searched PubMed, EMBASE and Web of Science to select relevant articles published between 1 January 2000 and 27 February 2022. We used the random-effects meta-analysis to estimate pooled point prevalence rates of thromboembolic events in studies with a minimum sample size of 30.

Results

We included five studies reporting data of 336 children and adolescents with primary APS and secondary APS (SAPS). Pooled point prevalence rates of initial general thrombosis, arterial thrombosis, venous thrombosis and stroke in individuals with seropositive APS were 98.2% (95% confidence interval [CI] 87.5–100), 27.6% (95% CI 21.4–34.2), 51.1% (95% CI 38.2–63.9) and 13.4% 95% CI (6.3–22.7), respectively. Pooled point prevalence rates of initial arterial and venous thromboses in children and adolescents with SAPS were 45.7% (95% CI 21.1–71.6) and 29.2% (95% CI 14.8–46), respectively.

Conclusion

Arterio-venous thromboembolism is highly frequent in children and adolescents with SAPS. More studies using thrombotic and non-thrombotic APS classification criteria are warranted to better assess the frequency and predictors of thromboembolism in age- and ancestry-diverse pediatric populations affected by different types of APS.

Keywords:
Antiphospholipid syndrome
Thromboembolic events
Epidemiology
Prevalence
Children
Adolescents
Resumen
Antecedentes y objetivo

Se trata de una revisión sistemática y un metaanálisis de la prevalencia de acontecimientos tromboembólicos en niños y adolescentes con síndrome antifosfolípido (SAF).

Métodos

Se realizaron búsquedas en PubMed, EMBASE y Web of Science para seleccionar los artículos pertinentes publicados entre el 1 de enero de 2000 y el 27 de febrero de 2022. Se utilizó el metaanálisis de efectos aleatorios para estimar las tasas de prevalencia puntual agrupadas de eventos tromboembólicos en estudios con un tamaño muestral mínimo de 30.

Resultados

Se incluyeron cinco estudios con datos de 336 niños y adolescentes con APS primario y APS secundario (SAPS). Las tasas de prevalencia puntual agrupadas de trombosis general inicial, trombosis arterial, trombosis venosa e ictus en individuos con SAF seropositivo fueron de 98,2% (intervalo de confianza [IC] 95%: 87,5-100), 27,6% (IC 95%: 21,4-34,2), 51,1% (IC 95%: 38,2-63,9) y 13,4% (IC 95%: 6,3-22,7), respectivamente. Las tasas de prevalencia puntual agrupadas de trombosis arteriales y venosas iniciales en niños y adolescentes con SAF secundario fueron de 45,7% (IC 95%: 21,1-71,6) y de 29,2% (IC 95%: 14,8-46), respectivamente.

Conclusión

La tromboembolia arteriovenosa es muy frecuente en niños y adolescentes con SAF. Se justifica la realización de más estudios que utilicen criterios de clasificación del SCA trombótico y no trombótico para evaluar mejor la frecuencia y los factores predictivos de la tromboembolia en poblaciones pediátricas de edad y ascendencia diversas afectadas por distintos tipos de SCA.

Palabras clave:
Síndrome antifosfolípido
Eventos tromboembólicos
Epidemiología
Prevalencia
Niños
Adolescentes

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